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Ukie: WHO gaming disorder diagnosis is based on "highly contested evidence"

Ukie CEO Dr Jo Twist OBE on the risks posed by the World Health Organisation's proposed definition, and the "irresponsible" reaction of mainstream media

This week the World Health Organisation published its proposed updates to the global diagnostic tool kit it calls ICD-11. The last time this was updated with 'modern diseases' to be treatable on various health care systems was in the 1990s.

When we found out about their proposal to include a gaming disorder (or disordered gaming as they sometimes refer to it) earlier this year, very quickly we coordinated with representative games trade bodies across the world to understand how this came to happen in such an un-transparent way and what it actually means.

Fast forward, and we now know much more about the WHO process: it is complicated and can have unintended consequences. But the reason this is causing much concern for the industry is because the evidence upon which the WHO has based this proposed inclusion is highly contested by scientists, medical practitioners, academics and experts across the world.

"By labelling a complex hobby as a disorder...we risk pathologising the wrong thing"

They sense the evidence is bundled with more general concerns about excessive screen time in the 21st century. There is a real concern that all games are being treated as a homogeneous whole with no understanding of the complexity and diversity of these digital worlds, which offer increasingly sophisticated stories, characters, competition, social connections, and fun. It also ignores potential underlying issues that may drive some people to seek solace in digital worlds. Indeed, we already know how much games can actively help people deal with the world around them in therapeutic ways.

This is not denying in any way that a very small minority play to excess for all sorts of reasons, but the jury is still out on addiction. The WHO says the International Classification of Diseases (ICD) exists as a diagnostic guide and framework, one to measure "abnormal behaviour" against. But the industry has an extremely proactive approach to technical and human solutions to this, as well as parent and carer guidance: this is part of modern parenting and care giving.

For us, the inclusion of gaming disorder speaks to a much bigger point: that there is little understanding about how and why people choose to spend their time in the 21st century. What is 'normal'? By labelling a complex hobby as a disorder compared to other entertainment media which seem far more familiar and acceptable, we risk pathologising the wrong thing.

"These facts matter, and there is still a long way to go and a lot more evidence to be scrutinised"

We risk giving parents and carers the excuse to rush to a medical solution instead of taking a step further in talking and understanding and enjoying these worlds together. We risk vulnerable people being exploited and mistreated. We risk overloading already vulnerable health systems.

But by far the most disappointing point of this week has been the mainstream media's irresponsible, sometimes hysterical reaction and misreporting, with some outlets equating gaming disorder to "digital heroin". The WHO calls it a gaming disorder, not gaming addiction.

It will not be adopted by the World Health Organisation formally until June 2019, a postponement that the global games industry unlocked. It is then up to different health systems and countries to work out how or if they implement it, and they won't start reporting on it until 2022. These facts matter, and there is still a long way to go and a lot more evidence to be scrutinised.

It is easy to throw games in the firing line for the sake of a headline. It has happened through the decades, from stories of violence and immorality in games affecting behaviour (again, highly contested and wrong) to the argument that loot boxes are gambling. The games industry is self-regulating, sustainable and takes its responsibility to players seriously. Stories calling games 'addictive' undermine that. Games are of course designed to be compelling and interesting - they want you to come back - but I challenge you to name one shop or brand that doesn't do that. No one intentionally makes a dull film franchise or a boring box-set.

The leisure activities of 21st century citizens means transacting and spending time in digital realms. There is an undeniable responsibility for the games sector to make sure that consumers are supported and that they understand how to enjoy these digital worlds safely and sensibly. But just because you might not fully understand why people choose to spend their time in digital worlds, as opposed to foregoing sleep to read that book or watch another episode of that TV series, it doesn't make one worse than the other. We as a society need to stop privileging the understandable and the physical over the digital.

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Jo Twist